Effect of secondhand smoke exposure on children’s health

Environmental smoke is a major risk factor for respiratory tract infections in children. In addition, parental smoking is one of the major sources of secondhand smoke (SHS) exposure for children. SHS exposure in children is associated with respiratory tract symptoms. Another illicit substance abused is marijuana, secondhand smoke from which can lead to visits to the emergency department (ED). Researchers have concluded that there is a strong relationship between SHS exposure and increased number of respiratory tract infections in children. Yet, SHS exposure from marijuana and its subsequent effect on children has not yet studied properly.

A new survey data presented at the Pediatric Academic Societies (PAS) meeting held earlier this May 2018 shared insights on this.

The purpose of this survey was to understand the association between marijuana induced SHS exposure, rates of tobacco sensitive conditions and emergency department (ED) visits by the children. Tobacco sensitive conditions include asthma, otitis media and other viral and respiratory tract infections.

Method of study

The research included a cross-sectional survey of the caregivers of the children. This survey was conducted at the ED in a tertiary care, urban, academic children’s hospital in Colorado. The data collected included demographics and the use of tobacco and/or marijuana from the caregivers, and medical history, number of emergency visits and number of tobacco sensitive conditions from the prior year from the child’s side.

Caregivers were classified into four categories based upon their use of tobacco and/or marijuana. They were categorized into four groups i.e. only tobacco use, only marijuana use, both tobacco and marijuana use, and neither tobacco nor marijuana use (Control group). A total of 1500 caregivers were a part of the survey. Poisson regression models were used to determine the variations of the total ED visits, as well as the tobacco sensitive health conditions. Results were expressed through incident rate ratio (IRR).


The survey concluded that 140 caregivers were found to have a habit of regular smoking of marijuana i.e., 9.2 % (7.7-10.7%), while 285 caregivers i.e.,  19 %( 17.1-21.1%) regularly smoked tobacco.

Children’s exposed to SHS are categorized into four categories i.e. marijuana only, tobacco only, marijuana and tobacco both and unexposed group. Amongst this marijuana the only group was consisting of 62 children i.e. 4.1 %, tobacco only group was consisting 213 numbers i.e. 14.2%, the group which was exposed to both was 75 in number i.e. 5%  and the unexposed group was 1147 in number which makes it 76.6 % of the total numbers.

When these groups were compared to each other it was seen that though all groups were having similar rates of visitations to the ED, the group with both marijuana and tobacco use had a significantly higher rate of ED visitation compared to the control group. Even the children belonging to this group had statistically higher rate of otitis media (OM) episodes (IRR = 1.81, 95%CI = 1.38, 2.35) as compared to the control group.

Differences for OM were not seen among other groups or for other tobacco sensitive conditions.

Researchers of this first-of-its-kind study on SHS exposure to marijuana spoke concluded that caregivers need to be doubly careful while smoking around children.

Reference –
Pediatric Academic Societies. Correlation between secondhand marijuana and tobacco smoke exposure and children ED visits: New research examines the impact of secondhand smoke from tobacco to understand marijuana’s impact on children.ScienceDaily. 5 May 2018.                        https://www.sciencedaily.com/releases/2018/05/180505091833.htm


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